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South Dakota rates for HCPCS A5093

Ostomy accessory; convex insert

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $1.74 / $1.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.74 / $1.87 / $2.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.64 / $1.64 / $3.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.00 / $3.00 / $3.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.87 / $3.16 / $80.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.09 / $1.66 / $3.12
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.50 / $3.00 / $3.93
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.36 / $3.05 / $5.74
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.27 / $2.67 / $3.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.97 / $1.82 / $2.73
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.46 / $2.46 / $2.46